| NPI | 1114493244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI KESS CEO 651-699-0206 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2018-10-16 |
| Last Update Date | 2023-04-27 |